Courtney Ann Keller, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN173592 Issued in AZ

Practice address

9165 W Thunderbird Rd Suite 201
Peoria, AZ 85381-4847

Phone

(623) 876-8420

Fax

(623) 285-2626

NPI assigned

May 27, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• Courtney Ann Kondos/Merck Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Banner Physician Specialists Arizona LLC 371 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.12 of 100Reported as group

Quality

76.35

Promoting interoperability

99

Improvement activities

40

Cost

71.55

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1821368218

  AZ

  Medicare reassignment Care Compare group
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1275889891

  AZ, Multi-Specialty

  Medicare reassignment NPD
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Chandler, AZ
  • NPI 1063260909
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Glendale, AZ
  • NPI 1073295036
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Queen Creek, AZ
  • NPI 1477301364
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Sun City West, AZ
  • NPI 1548538069
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Peoria, AZ
  • NPI 1588933139
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Glendale, AZ
  • NPI 1821846726
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Gilbert, AZ
  • NPI 1861249740
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Surprise, AZ
  • NPI 1972351815
  Care Compare group
• Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Peoria, AZ
  • NPI 1992073498
  Care Compare group
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • Gilbert, AZ
  • NPI 1124374822

  Multi-Specialty

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1336307495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9165 W THUNDERBIRD RD SUITE 201",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814847",
            "telephone_number": "623-876-8420",
            "fax_number": "623-285-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9165 W THUNDERBIRD RD SUITE 201",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814847",
            "telephone_number": "623-876-8420",
            "fax_number": "623-285-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "COURTNEY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP7558",
            "primary": false
        },
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "ND",
            "license": "46",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "ND",
            "license": "46",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN173592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054517",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "979757",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "PENDING",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ND",
            "identifier": "PENDING",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "KONDOS/MERCK",
            "middle_name": "ANN",
            "credential": "APRN-CNS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Keane, R.D.H.
• Andrea Eileen Keefer, RDH
• Mikaela Keene
• Keith Bangart DPM PC
• Adrijana Kekic, PHARMD
• Cory Kempton, DO
• Dawn M Kempton, SLPA
• Kenneth J Prebil Surgery Associates, P.C.
• Randall Kertz, D.C.
• Victoria Marie Kes, D.C.

• All providers in Peoria, AZ
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.